Puram Vikram Venkata, Berry Brent, Ghannam Malik, Furuya Yuka
Department of Internal Medicine, Stanford University, Stanford, CA 94304, USA.
Department of Neurology, University of Minnesota, Minneapolis, MN 55414, USA.
Life (Basel). 2022 Sep 21;12(10):1471. doi: 10.3390/life12101471.
Hyperammonemia is a condition that may result after solid organ transplantation, particularly lung transplantation. However, it is very uncommon for this presentation to occur more than 30 days post-transplantation. Hyperammonemia and the resulting encephalopathy typically manifest with altered sensorium, a clinical situation which is not often included in the differential diagnosis of presumed nonconvulsive status epilepticus (NCSE). Seizures are common among this subset of patients with hyperammonemia and may be refractory to traditional treatments. Evidence of elevated intracranial pressure by invasive monitoring and neuroimaging findings of diffuse cerebral edema are commonly reported. Here we examine the therapeutic importance of identifying the specific cause of hyperammonemic encephalopathy, a condition which may result in status epilepticus and ultimately cerebral edema or even brain death.
高氨血症是实体器官移植后可能出现的一种病症，尤其是肺移植后。然而，这种情况在移植后30天以上出现极为罕见。高氨血症及其引发的脑病通常表现为意识改变，而这种临床情况在疑似非惊厥性癫痫持续状态（NCSE）的鉴别诊断中并不常被考虑。癫痫发作在高氨血症患者亚组中很常见，且可能对传统治疗无效。通过有创监测发现颅内压升高以及弥漫性脑水肿的神经影像学表现屡见不鲜。在此，我们探讨识别高氨血症性脑病特定病因的治疗重要性，这种病症可能导致癫痫持续状态，并最终引发脑水肿甚至脑死亡。
